Investigation Procedures & Methods Flashcards

Which Oregon statute primarily governs the reporting of suspected insurance fraud by insurers?

Answer: ORS Chapter 746

ORS Chapter 746 covers insurance trade practices and includes mandatory fraud reporting requirements for insurers in Oregon.

When an Oregon inspector identifies a pattern of claims from the same medical provider, the MOST appropriate investigative technique is:

Answer: Conduct a link analysis to map relationships between claimants and the provider

Link analysis maps relationships between claimants, providers, and incidents to detect organized fraud schemes.

An investigator is preparing to interview a witness in an Oregon insurance claim. Which approach is MOST effective for obtaining accurate information?

Answer: Use open-ended questions to allow the witness to narrate events freely

Open-ended questions allow witnesses to provide narrative accounts, reducing interviewer bias and capturing details the investigator may not have anticipated.

In Oregon, the 'two-year look-back' in insurance investigations typically refers to:

Answer: Reviewing prior claim history within two years to identify patterns

Reviewing prior claims within a two-year window helps investigators identify patterns of repeated or staged losses.

When gathering digital evidence during an Oregon insurance investigation, chain of custody is critical because it:

Answer: Ensures the evidence is admissible and has not been tampered with

An unbroken chain of custody demonstrates that digital evidence has not been altered, making it admissible in legal proceedings.

Which of the following is a RED FLAG indicator of a staged vehicle accident claim in Oregon?

Answer: Multiple claimants all share the same attorney and treatment facility

Multiple claimants using the same attorney and treatment facility after a single accident is a classic indicator of a staged collision ring.

An Oregon insurance investigator's field notes should ALWAYS include:

Answer: Date, time, location, and objective observations only

Field notes must be objective and factual, recording only what was directly observed with specific date, time, and location references.